Abstract
Context
Anxiety in patients with cancer is highly prevalent; yet it remains underestimated
and inadequately assessed. Little is known about predictors for anxiety in hospitalized
patients with cancer. Insight in predictors should improve recognition and enable
a targeted approach.
Objectives
To determine the prevalence of anxiety and predictors for anxiety in hospitalized
patients with cancer at different stages of disease.
Methods
A cross-sectional analysis of patients with cancer admitted to the Utrecht University
Medical Center in 2015–2018 was conducted. The Utrecht Symptom Diary, an adapted Dutch
version of the Edmonton Symptom Assessment System, was used to assess symptom burden
on a numeric rating scale (0 = no symptom and 10 = worst possible symptom). Scores
≥4 were considered clinically relevant. All patients completed the Utrecht Symptom
Diary as part of routine care. The first questionnaire after admission was selected.
Using multivariable linear regression, the predictive value of potential predictors
on anxiety was analyzed.
Results
In total, 2144 patients were included, of which 22% reported clinically relevant anxiety.
The prevalence of anxiety was highest (36%) in patients receiving symptom-directed
palliation only. In the total group, female gender, younger age, depressed mood, sleeping
problems, dyspnea, and cancer of the head and neck were predictive of anxiety. Throughout
all stages of disease, depressed mood was consistently the strongest predictor.
Conclusion
We found a high prevalence of anxiety in hospitalized patients with cancer. It is
recommended to explore anxiety in hospitalized patients with cancer, in particular
when they experience depressed mood. Structural use of a symptom diary during hospitalization
facilitates the recognition of anxiety and concurrent symptoms.
Key Words
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Article info
Publication history
Published online: April 16, 2020
Accepted:
April 7,
2020
Identification
Copyright
© 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
